The EBAI CME 2013 - 21st and 22nd of September 2013, Golden Valley Resort, Ghodbunder Road, Thane West, Mumbai.

1. Disclaimer
This presentation is based on my experiences in this field in the last 20 years.
It is an attempt to present problems faced so as to find solutions for the future.
I appreciate and respect the work being done by all concerned agencies.

2. Flow of the Presentation
 Registration problems
 HCRP to enhance collection
 Centralised telephone nos.
 Centralised waiting list

3. REGISTRATION & RENEWAL
 Eye Banks, Eye donation centres &
Keratoplasty centres have to renew
registration every 5 years.
 Corneal Surgeons operating in keratoplasty
centres need to be re-registered every 5 yrs.
 Difficult task.

5. Problems with Registration
Experience Certificate
 Established keratoplasty surgeons may not have this
as there were no fellowships, training programs or
keratoplasty centres long back.
 This rule should be omitted for those doing
keratoplasties for > --yrs / have done > -- surgeries.

6. Problems with
Registration
Registration under Bombay Shop &
Establishments Act
 To run a nursing home only a nursing home
registration is required.
 Nursing homes don’t have this registration.
 They will be forced to do this additional reg.
 Clause should be deleted.

7. Problems with
Registration
NURSE
 Most small ophthalmic set ups in Mumbai
run with ophthalmic assistants and do not
require or afford a registered nurse.
Big shortage of trained nurses.
 This needs to also permit assistant or
technician - trained / -- yrs experience.

8. Time Frame for Renewal of Registration of Eye
Banks & Keratoplasty centres from health
authorities
 Process often take
several months to > 1yr.
 Interrelated registrations
get expired & delay
registration process.
 Permit the Eye Banks
and Keratoplasty centres
to continue work in
window periods.

9. Bottom-line
 Registration today is a very difficult task.
 It is more profitable to pursue other
ophthalmic sub specialities.
 Many I know, have given up efforts to
register with the authorities.
Please make the process simple & fast.

10. Final Impact
 Young Ophthalmologists will not pursue
cornea speciality.
 Eye Collection may drop due to loss of
interest.
 The efforts to be able to perform keratoplasty
may not be worth the headaches.
 Our patients will have to travel to other states
to get surgery done.

11. SOLUTION
Coordination
Committee
EYE BANKS
Keratoplasty
Centres
Health Deptt.
A committee which has participation from both sides & which can work
together and find acceptable solutions to the current and future problems.
West Zone Chapter

12. Flow of the Presentation
 Registration problems
 HCRP to enhance collection
 Centralised telephone nos.
 Centralised waiting list

13. HCRP to increase collection
HCRP is the answer for increasing cornea collection.
We need to take help from Organ transplant networks.
 MCFOT (Maharashtra Confederation for Organ Transplantation)
 ZTCC (Zonal Transplantation and Coordination Centre)
 27-hospital network to retrieve and distribute solid
organs & are equipped with grief counselors.
 Run through Public / Private Partnership.

14. HCRP to increase collection
 NAB is a member of the ZTCC.
 EBAI should also join the ZTCC.
 Counselors for solid organs could also
counsel for corneas and we could establish
a HCRP in these 27 hospitals.
 This association will also help us to address
problems faced by the Eye Banks.
 HCRP must be a mandatory function of all
Eye banks.

15. Flow of the Presentation
 Registration problems
 HCRP to enhance collection
 Centralised telephone nos.
 Centralised waiting list

16. Eye Bank Telephone
Numbers
Centralised Single Telephone number.
 Many calls are missed as eye banks are
often not reachable.
 Single telephone number which should
receive all calls in each district and then
forward them to eye banks / collection
centres according to geographic zones.
 EBAI needs to ensure that 1919 nos. are
provided to established Eye Banks.

17. • 1919• 1919
• 1919• 1919
South
Mumbai
North
Mumbai
New
Mumbai
Thane
Professionally run 24hrs telephone network

18. Centralised Waiting List
 We need to have a centralised list online for
each district / zone where each keratoplasty
centre should upload new patient
registrations.
 This will improve tissue utilisation & provide
fair distribution.
 It is not possible for every patient to register
with all Eye Banks.

19. Central List
KP
Centre
KP
Centre
KP
Centre
KP
Centre
Eye
Bank
Eye
Bank

20. Processing Fees
 No control over the same.
 Now reached 10,000 or even more at
some centres.
 Profit making centres ?
 Realistic calculation of expenditure.
 Norms to give concession to the poor.
 Most Eye Banks refuse concessions.

21. An Excellent Source of
Guidelines and Information.
I hope we will have a new
updated edition at least
every 5 years.

22. A few more initiatives & efforts by the EBAI West Zone will
go a long way in finding acceptable solutions in Maharashtra.

23. ‘I don’t know who I am. I have a donor heart, a donor
kidney, a donor liver, a donor cornea, a donor lung….:
Thank You.

24. Changes in Laws needed
that can increase collection.
 Permission to trained technicians to remove eyes.
 Required Request : Doctor has to request relatives
for eye donation in all cases of death.
 Presumed Consent : All corneas can be removed
unless there is a specific objection from next of kin.
 Unclaimed bodies : Presently organs cannot be
removed before 48 hours.
 Postmortem cases : Permission to remove cornea
unless the dead person had wished not to donate.
 Grief Counsellors - Mandatory requirement for all
large hospitals.

26. Problems with Registration
MCI Registration
 A doctor who has Medical Council of India
registration number can practice anywhere
in the country and should not be asked to
re register with state as per rule.
 A doctor registered with another state medical
council should re-register with state where he
is in practice.

27. Rejecting Eye Donation Calls ?
 Age – Varies with different Eye Banks ?
No clear guidelines
 Absolute Contraindications for Use
eg. Septicemia, HIV, Hep B
 Why ? – To improve utilisation rates.

28. Improving Utilisation rates
 Counselling very elderly donors that
eyes may be used only for research if
found unfit for surgery.
 Donors where eyes cant be used should
be clearly counselled.